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Functional Improvement Following Revision Surgery in a Patient with the Dual Disability of a Complicated Residual Limb and Contralateral Hemiplegia: A Case Report.

Ki Hyun BYUN ; Dong Seok YANG ; Baek Hee JANG

Journal of Korean Physical Therapy.2018;30(5):199-203. doi:10.18857/jkpt.2018.30.5.199

The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.
Amputation ; Ankle ; Canes ; Extremities* ; Foot Orthoses ; Hemiplegia* ; Humans ; Hyperplasia ; Lower Extremity ; Neuroma ; Putaminal Hemorrhage ; Stroke ; Walking

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The Effects of Computerized Gaming Program on Cognition in Children with Mental Retardation: A Case Study.

Seon Chil KIM ; Ju Young HEO ; Hwa Kyung SHIN ; Byeong Il KIM

Journal of Korean Physical Therapy.2018;30(5):193-198. doi:10.18857/jkpt.2018.30.5.193

PURPOSE: The purpose of this study was to analysis of effectiveness between cognitive function assessment scores and gaming cognitive rehabilitation system in children with intellectual impairment. METHODS: Five children (male=5, age=10.00±0.80) with intellectual impairment participated in this study and were randomly assigned to the experiment that played (received) gaming cognitive rehabilitation system (Neuroworld). The children were applied 2 times a week for 30 minutes during 3 months. The children were assessed K-WSIC-VI (Korean-Wechsler intelligence scale for children-fourth edition) and recorded that gained score in gaming cognitive rehabilitation system before and after intervention. K-WSIC-VI contained five primary index scores: verbal comprehension index, visual spatial index, fluid reasoning index, working memory index, and processing speed index. Gaming cognitive rehabilitation system scoring was composed visual recall, target recall, sequence recall, selective attention, continuous attention, and exploration. RESULTS: In the intelligence quotient (IQ) of K-WSIC-VI, there were significant increased in all children. The visual recall item was highest effective in all children. However, sequential recall showed the lowest improvement in all children. The performance speed of selective attention item was decreased, this means that children's skills have improved. Also, their ability to explore has improved significantly. CONCLUSION: In conclusion, gaming cognitive rehabilitation system was significant effectiveness in cognitive function in some categories for children with intellectual impairment. However, the visual recall and performance speed don't represent of all cognitive function. Therefore, further studies will need to verify by applying more subject and longer duration.
Child* ; Cognition* ; Comprehension ; Humans ; Intellectual Disability* ; Intelligence ; Memory, Short-Term ; Rehabilitation

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Relationship between Functional Fitness and Break Response in Elderly Drivers: Comparison with Young Driver.

Ga Eun KIM ; Ye Eun CHOI ; Su Seong YANG ; Sun A KIM ; Young Sook BAE

Journal of Korean Physical Therapy.2018;30(5):187-192. doi:10.18857/jkpt.2018.30.5.187

PURPOSE: This study compared the functional fitness and brake response of elderly and young drivers to confirm the correlation between the functional fitness and brake response. METHODS: This study was a cross sectional observational design. Older drivers (>65age, n=21) and young adult drivers (20–40aged, n=20) were enrolled as subjects. The functional fitness of the subjects was measured using a senior fitness test consisting of a back scratch (BS), chair sit and reach (CSR), arm curl (AC), chair stand up (CSU), foot up and go (8-FUG), and 2-minute step (2-MS). The brake response used the virtual driving simulator to measure the brake reaction time (BRT) and braking distance (BD) according to the pedestrian protection and traffic signal compliance. RESULTS: The older drivers had a lower BS (p < 0.000), CSU (p=0.040), and 8-FUG (p=0.011) than the young adult drivers. BS and 8-FUG showed a significant positive correlation with the BRT and BD of pedestrian protection and traffic signal compliance. CSU showed a significant negative correlation with the BRT of pedestrian protection and traffic signal compliance. CONCLUSION: These findings suggest that the flexibility of the upper extremity, lower extremity strength, and agility are strongly correlated with the driving performance of elderly drivers.
Aged* ; Arm ; Compliance ; Foot ; Humans ; Lower Extremity ; Pliability ; Reaction Time ; Upper Extremity ; Young Adult

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Influence of Home Based Exercise Intensity on the Aerobic Capacity and 1 Year Re-Hospitalization Rate in Patients with Chronic Heart Failure.

Ho Youl RYU ; Ki Song KIM ; In Cheol JEON

Journal of Korean Physical Therapy.2018;30(5):181-186. doi:10.18857/jkpt.2018.30.5.181

PURPOSE: This study investigated the effects of home-based exercise intensity on the aerobic capacity and 1 year re-hospitalization rate in patients with chronic heart failure (CHF). METHODS: Forty seven patients with CHF (males 33, females 14, age 61.3±9.8 years) participated in this study. The patients were allocated randomly to 3 groups in accordance with home-based exercise intensity: no home based exercise (NHE, 40%, n=19), moderate intensity home-based exercise (MIHE, 43%, n=20), and high intensity home based exercise (HIHE, 17%, n=8). All patients completed the symptom-limited cardiopulmonary exercise (CPX) test safely at the cardiac rehabilitation hospital. RESULTS: The NHE group significantly showed lower peak VO2 and a higher VE/VCO2 slope than the MIHE (p < 0.05) and HIHE (p < 0.01) groups. On the other hand, the NHE group did not show significant differences in the other hemodynamic responses, such as heart rate (HR) max, HR reserve, maximal systolic blood pressure (SBP), and SBP reserve. Nine out of 19 NHE patients (47%) were re-hospitalized related to heart disease and two out of 20 MIHE (10%) patients were re-hospitalized, but nobody in the HIHE group were re-hospitalized within 1 year from the CPX test. CONCLUSION: In patients with CHF, home-based self-exercise is one of the important factors for reducing the re-hospitalization rate. In addition, improved aerobic capacity is strongly associated with a lower re-hospitalization rate. In particular, re-hospitalized CHF patients showed significant differences in respiratory parameters and hemodynamic parameters compared to the non-re-hospitalized patients.
Blood Pressure ; Female ; Hand ; Heart Diseases ; Heart Failure* ; Heart Rate ; Heart* ; Hemodynamics ; Humans ; Rehabilitation ; Self Care

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Change of Pain, Lumbar Sagittal Alignment and Multifidus after Sling Exercise Therapy for Patients with Chronic Low Back Pain.

Seung Jin PARK ; Ji Hyun MOON ; Yun A SHIN

Journal of Korean Physical Therapy.2018;30(5):173-180. doi:10.18857/jkpt.2018.30.5.173

PURPOSE: This study examined the effects of sling exercise therapy on vertebral alignment, VAS, muscle activity, and multifidus of patients with chronic low back pain. METHODS: Simple random sampling was used to divide the patients (n=116) into the sling exercise therapy group (SETG) and conservative physical therapy group (CPTG), with each group provided a intervention program in 3 sessions a week for 12 weeks. The lumbar lordosis angle (LLA), lumbar intervertebral disc angle (LIVDA) for vertebral alignment, lumbar muscle activity, and multifidus atrophy were measured before and after the intervention. RESULTS: SETG showed significant changes in LLA, LIVDA of rate of change (delta score), and in relieving pain. The right-left balance gap for the lumbar dynamic muscle activity decreased after the intervention. The SETG showed significant changes in the grade of lumbar multifidus atrophy. CONCLUSION: The sling exercise therapy program is an effective exercise therapy method on vertebral alignment, muscle activity, recovery from multifidus atrophy, and pain relief for patients with chronic low back pain.
Animals ; Atrophy ; Exercise Therapy* ; Humans ; Intervertebral Disc ; Lordosis ; Low Back Pain* ; Methods ; Paraspinal Muscles*

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Effects of Sling and Resistance Rotation Exercises on Pelvic Rotation and Pain in Patients with Chronic Low Back Pain.

Dae Hyun KIM ; Tea Ho KIM

Journal of Korean Physical Therapy.2018;30(5):166-172. doi:10.18857/jkpt.2018.30.5.166

PURPOSE: This study compared the different sling and resistance exercises on pelvic rotation during active straight leg raises (ASLR) and on pain in patients with chronic low back pain (CLBP). METHODS: Twenty subjects were divided randomly into a sling group (SG) and a resistance exercise group (REG). Internal oblique (IO), external oblique (EO), rectus abdominis (RA), and rectus femoris (RF) muscle activity; pelvic rotation angle during ASLR; and visual analogue scale, pressure pain threshold were measured. Sling and resistance exercises were then performed for 30 minutes and the measurements taken again. RESULTS: Both groups showed significantly lower RF muscle activity and significantly higher EO and IO muscle activity (p < 0.05). The RA muscle activity decreased significantly in the SG, but increased significantly in the REG (p < 0.05). The pelvic rotation angle was significantly lower in the SG (p < 0.05). The pain press threshold increased significantly in both groups (p < 0.05). The visual analogue scale decreased significantly in the SG (p < 0.05). CONCLUSION: Both exercises appear to be beneficial for modifying the muscle activity and pain control in the intervention of CLBP. On the other hand, the sling was more effective in increasing the pressure threshold than resistance exercise, and the pelvic rotation angle was reduced. Therefore, both exercises can help patients with CLBP change their muscle activity and control pain. CLBP patients should use a sling for short periods of time to learn to reduce the pain and control pelvic rotation.
Back Pain ; Exercise* ; Hand ; Humans ; Jupiter ; Leg ; Low Back Pain* ; Pain Threshold ; Quadriceps Muscle ; Rectus Abdominis

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Effect of Game-Based Balance Training with CIMT on Pain, Muscle Strength, Range of Motion and Dynamic Balance in Female Patients with Total Knee Replacement.

Hyo Bin LEE ; Ho Suk CHOI ; Won Seob SHIN

Journal of Korean Physical Therapy.2018;30(5):159-165. doi:10.18857/jkpt.2018.30.5.159

PURPOSE: The aims of this study were to determine if game-based training with constraint-induced movement therapy (CIMT) is effective in improving the balance ability in female patients with a total knee replacement, and to provide clinical knowledge of CIMT game-based training that allows the application of total knee replacement. METHODS: Thirty-six patients who had undergone a total knee replacement were assigned randomly to CIMT game training (n=12), general game training (n=12), and self-exercise (n=12) groups. All interventions were conducted 3 times a week for 4 weeks. All patients used a continuous passive motion machine 5 times a week and 2 times a day for 4 weeks. The visual analog scale (VAS), muscle strength of knee flexion and extension, and range of motion (ROM) of knee flexion and extension were assessed, and the functional reach test (FRT), and timed up and go (TUG) test were performed to evaluate the balance ability. RESULTS: All 3 groups showed significant improvement in the VAS, knee flexion and extension muscle strength, FRT, and TUG test after the intervention (p < 0.05). Post hoc analysis revealed significant differences in FRT, and TUG of the CIMT game training group compared to the other group (p < 0.05). CONCLUSION: Although the general game training and CIMT game training improved both the knee extension muscle strength and dynamic balance ability, CIMT game training had a larger effect on dynamic balance control.
Arthroplasty, Replacement, Knee* ; Female* ; Humans ; Knee ; Muscle Strength ; Myalgia* ; Range of Motion, Articular* ; Visual Analog Scale

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Gait Recovery Characteristic According to the Injury Aspect of Descending Motor Pathway in a Chronic Stroke Patient: a Case Study

Sang Seok YEO

Journal of Korean Physical Therapy.2022;34(6):326-331. doi:10.18857/jkpt.2022.34.6.326

Purpose: The stroke patients have gait dysfunction due to impaired neural tracts; corticospinal tract (CST), corticoreticular pathway (CRP), and vestibulospinal tract (VST). In this study, we investigated characteristics of gait pattern according to the injury aspect of the neural track in a stroke patient. Methods: One patient and six control subjects of similar age participated. A 19-year-old male patient with spontaneous intracerebral hemorrhage on right basal ganglia, thalamus, corona radiata and cerebral cortex due to arteriovenous malformation rupture. Diffusion tensor imaging (DTI) data was acquired 21 months after the stroke. Kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system. Results: On 21 months DTI, the CST and CRP in affected hemisphere showed severe injury, in contrast, the VST in affected hemisphere showed intact integrity. Result of gait analysis, walking distance and speed were significantly decreased in a patient. The stance rate of unaffected lower limb, the swing rate of affected lower limb and the duration of double stance significantly increased compared with normal control. The knee and hip joint angle were significantly decreased in a patient. Conclusion We found recovered independent gait ability may be associated with unimpaired VST in a patient with severe injury in CST and CRP.

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Change of Balance Ability in Subjects with Pain-Related Temporomandibular Disorders

Ja Young KIM ; Sang Seok YEO

Journal of Korean Physical Therapy.2022;34(6):321-325. doi:10.18857/jkpt.2022.34.6.321

Purpose: Temporomandibular disorder (TMD) is a condition defined as pain and dysfunction of temporomandibular joints and masticatory muscles. Abnormal interconnections between temporomandibular muscles and cervical spine structures can cause the changes of postural alignment and balance ability. The aim of this study was to investigate changes in static balance ability in subjects with painrelated TMD. Methods: This study conducted on 25 subjects with TMD and 25 control subjects with no TMD. Pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured using a pressure algometer. Static balance ability was assessed during one leg standing using an Inertial Measurement Unit (IMU) sensor. During balance task, the IMU sensors measured motion and transfer movement data for center of mass (COM) motion, ankle sway and hip sway. Results: PPTs of masseter and temporalis muscles were significantly lower in the TMD group than in the control group (p < 0.05). One leg standing, hip sway, and COM sway results were significantly greater in the TMD group (p < 0.05), but ankle sways were not different between group. Conclusion We suggest pain-related TMD is positively related to reduced PPTs of masticatory muscles and to static balance ability. These results should be considered together with global body posture when evaluating or treating pain-related TMD.

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Effect of Elastic Aids (Bands) on Functional Reach Test in Patients with Spinal Cord Injury: Pilot Study

Jong Ho KANG ; Tae Sung PARK

Journal of Korean Physical Therapy.2022;34(6):317-320. doi:10.18857/jkpt.2022.34.6.317

Purpose: This study aimed: to confirm the balance ability of patients with spinal cord injury in the sitting state through a functional reach test using an elastic aid; and to propose a balance improvement plan. Methods: The study evaluated seven patients with spinal cord injury who could maintain a sitting posture through minimum assistance. A functional reach test was performed before and after wearing an elastic aid while sitting on a chair, and the effects before and after use of the elastic aid were compared and analyzed through a motion analyzer. Results: In the functional reach test, the forward movement distance of the hand was 97.45 mm before wearing the elastic aid, but significantly increased to 131 mm after wearing the aid (p < 0.05). Corresponding forward movement distances for the shoulder were 81.26 mm and 113 mm (p < 0.05 for the increase). There was no statistically significant change in lateral functional arm extension. Conclusion It was confirmed, through a functional reach test, that trunk stability in patients with spinal cord injury increased with use of an elastic aid. In future, more efficient rehabilitation treatment programs will be possible if trunk stability in patients with spinal cord injury is improved by using elastic aids, and if various exercise treatments are also included in the rehabilitation programs.

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